In issue
The plaintiff’s primary case was that Calvary Hospital (‘the Hospital’) should have performed a laparoscopy on her first admission on the basis that this would have revealed the ectopic pregnancy and allowed for a salpingostomy (procedure to remove an ectopic pregnancy from a fallopian tube, but without removing the tube itself). She further contended that had a salpingostomy been performed, she would have had a reasonable chance of retaining her fertility.
The plaintiff’s secondary case was that the Hospital breached its duty of care by discharging her on 1 August 2019, in circumstances where she was in pain, an ectopic pregnancy had not been ruled out, and without adequate advice regarding the seriousness of her condition. The plaintiff’s argument was that had she remained at Hospital when her pain increased, a successful salpingostomy may have been performed, or in the alternative, she would not have sustained psychological injury caused by the distress and fear she suffered leading up to the emergency surgery.
The background
The plaintiff, Emily Hartfield, had a history of two miscarriages and a previous ectopic pregnancy (pregnancy implantation outside of the womb) resulting in the removal of one of her fallopian tubes. She presented to Calvary Hospital on the morning of 31 July 2019, at five weeks pregnant with pain and bleeding, fearing that she may be suffering from a second ectopic pregnancy. She was admitted then discharged the next day, after being diagnosed with a pregnancy of unknown location (neither a miscarriage nor an ectopic pregnancy had been ruled out).
The plaintiff’s pain increased, and she returned to the Emergency Department of the Hospital in the early hours of the next morning. She was subsequently diagnosed with an ectopic pregnancy and underwent a laparoscopic left salpingectomy to remove her remaining fallopian tube. The plaintiff developed symptoms of depression, anxiety, and post-traumatic stress as a result.
The decision at trial
The plaintiff failed to establish liability on her primary case – that is, that the Hospital ought to have performed a laparoscopy during her first admission. The Court found that even if a laparoscopy had been performed, the plaintiff failed to establish that a successful salpingostomy would have followed.
However, the Court decided that the Hospital breached its duty of care by discharging the plaintiff without providing appropriate care and management. The Court accepted that this breach caused the plaintiff to suffer physical and psychological harm as her condition deteriorated at home as she became fearful for her life and the loss of her pregnancy.
The Court dismissed the Hospital’s contention that the plaintiff was contributorily negligent by failing to return to the hospital immediately when her pain worsened. Rather, the Court suggested that the injuries would not have occurred but for the Hospital’s inadequate advice regarding the danger of her condition. The Court awarded the plaintiff a total sum of $118,306 including general damages, economic loss, and future psychological treatment. The Court did not award the plaintiff with damages relating to loss of fertility and post-operative physical symptoms.
Implications for you
Medical practitioners must provide adequate and appropriate advice to patients prior to discharge and inform them of the need to return to hospital should their condition deteriorate.
Hartfield v Calvary Healthcare ACT Ltd (No 4) [2025] ACTSC 488
